| NPI | 1255980074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZOLA GOURDIN Owner 702-801-4734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2019-09-04 |